NPI | 1679991442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60963002) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D86846) |
Enumeration Date | 2014-03-31 |
Last Update Date | 2020-07-01 |